The short answer

Medicare Open Enrollment runs October 15 through December 7, 2026, and the plan you pick takes effect January 1, 2027. If you take a GLP-1 — or expect to — this is the one window each year when you can change how your drug coverage works. The GLP-1 Bridge is not affected by which plan you choose, but almost everything else about your drug costs is.

The dates that matter

  • End of September 2026 — your plan must mail you an Annual Notice of Change (ANOC). This is the document that tells you what is changing in your plan for 2027.
  • October 15 – December 7, 2026 — Open Enrollment (also called the Annual Enrollment Period, or AEP). You can join, switch, or drop a Part D drug plan or a Medicare Advantage plan, or move between Original Medicare and Medicare Advantage.
  • January 1, 2027 — your new coverage begins.
  • January 1 – March 31, 2027 — the Medicare Advantage Open Enrollment Period, a narrower second chance if you are already in an Advantage plan.

Do not throw away the ANOC. It is the cheapest ten minutes of research you will do all year, because plans change their formularies, tiers, premiums, and pharmacy networks every January — including for GLP-1s.

What changes for 2027

CMS finalized the 2027 standard Part D numbers in its Contract Year 2027 Rate Announcement:

  • The annual out-of-pocket cap rises to $2,400, up from $2,100 in 2026.
  • The standard deductible rises to $700, up from $615 in 2026.

Once your out-of-pocket spending on covered drugs reaches the cap, you pay $0 for covered prescriptions for the rest of the calendar year. Everything you pay toward the deductible counts toward that cap, so no spending is wasted. Our guide to the Medicare drug cap and GLP-1s walks through how the phases fit together.

Keep in mind that these are the standard figures. Individual plans can set a lower deductible, different tiers, and different copays, which is exactly why comparing plans matters.

If you are on the GLP-1 Bridge, read this first

The Medicare GLP-1 Bridge runs from July 1, 2026 through December 31, 2027, and it operates outside the Part D benefit's coverage and payment flow. Three consequences worth understanding before you shop:

  1. Your plan choice does not decide your Bridge access. Part D sponsors do not have to opt in, and they carry no risk for Bridge drugs. What you do need is Part D drug coverage of some kind — a standalone drug plan (PDP), a Medicare Advantage plan with drug coverage (MA-PD), a Special Needs Plan, an employer or union group waiver plan, or LI NET. If you drop drug coverage entirely, you lose Bridge eligibility.
  2. Your $50 copay does not count toward the 2027 cap or deductible. Because a separate program covers the drug, the copay does not appear on your Part D Explanation of Benefits and does not move you toward that $2,400 threshold. This is covered in more detail in our Bridge cost guide.
  3. Your prior authorization carries forward. Once approved, your Bridge prior authorization is valid through December 31, 2027 — including refills and dose changes — unless you switch to a different GLP-1. Changing drugs means a new authorization.

If you have kidney disease, heart failure, or high blood pressure

These conditions work in the opposite direction from the ones in the next section: they help you qualify for the Bridge rather than ruling you out.

The Bridge uses a three-tier clinical ladder. A BMI of 35 or higher qualifies on its own. A BMI of 30 or higher qualifies if you also have chronic kidney disease of stage 3 or higher, diagnosed heart failure, or high blood pressure that is hard to control. A BMI of 27 or higher qualifies with pre-diabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease. You only need to meet one tier — our guide to the conditions that lower your BMI requirement works through each one.

If that describes you, your Open Enrollment job is the simpler one. Your $50 copay will not change no matter which plan you pick, so the only Bridge-related mistake available to you is dropping drug coverage altogether.

But do not stop there. Kidney disease and heart failure usually arrive with a list of other prescriptions, and those run through Part D and do count toward the $2,400 cap. For this group, comparing 2027 formularies on your non-GLP-1 medications is where the real money is.

One exception: if you also have type 2 diabetes, that diagnosis governs and you are not Bridge-eligible — read the next section instead.

A safety note specific to kidney disease: GLP-1 side effects that cause fluid loss deserve extra care when kidney function is already reduced. See GLP-1s, dehydration, and kidney health in seniors before you start.

If you have type 2 diabetes, sleep apnea, or fatty liver disease

This is the group with the most to gain from careful shopping. A diagnosis of type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease makes you ineligible for the Bridge — but your Part D plan may cover a GLP-1 for you directly.

That is not a consolation prize. A GLP-1 covered through Part D behaves completely differently from a Bridge drug: the spending counts toward your deductible and your $2,400 out-of-pocket cap, it can be reduced by Extra Help if you qualify, and it can be spread across the year using the Medicare Prescription Payment Plan. In a high-cost year, plan-covered coverage can end up costing less than $50 a month once you hit the cap.

So if you are in this group, comparing formularies is the single highest-value thing you can do during Open Enrollment. See Medicare Advantage GLP-1 coverage and does Medicare cover Ozempic for how these drugs are typically treated.

How to check whether a 2027 plan covers your GLP-1

Work through this in order:

  1. Find the plan's formulary for 2027, not 2026. Plans publish these ahead of Open Enrollment.
  2. Search for your exact drug and form. Wegovy, Zepbound, Ozempic, Mounjaro, and Foundayo are treated differently, and the form matters — a plan may cover an injection but not a tablet.
  3. Check the tier and the restrictions. A drug can be "covered" and still sit behind prior authorization, step therapy, or a quantity limit.
  4. Check the pharmacy network. A preferred pharmacy can change your copay substantially, and specialty drugs are sometimes restricted to specific pharmacies.
  5. Price the whole year, not the month. Add the premium, the deductible, and your expected copays, then compare against the $2,400 ceiling.
  6. Call the plan and ask directly. Get the answer for your specific drug, dose, and diagnosis.

If you are considering a change specifically to get GLP-1 coverage, our guide on switching Medicare plans for GLP-1 coverage covers the tradeoffs in more depth.

The 2028 question worth thinking about now

The Bridge ends December 31, 2027. Unless something replaces it, anyone relying on the $50 copay will need another path in 2028 — most likely a Part D plan that covers their drug, which brings you back to formularies. You do not need to solve this during the 2027 Open Enrollment, but if you are choosing between two similar plans, the one with a stronger GLP-1 formulary is the safer long-term pick.

Where to start

If you are not sure whether you qualify for the Bridge in the first place, our eligibility quiz walks through the BMI and condition rules in about two minutes. If you need a prescriber who is comfortable managing GLP-1s for Medicare patients, start with our provider directory.

Data note

Data as of August 2026. Open Enrollment dates, the 2027 standard Part D figures, and the Medicare GLP-1 Bridge rules described here come from Medicare.gov and CMS. Plan-specific costs, formularies, and networks vary — confirm current details with your plan or Medicare.gov before making a decision. This is general information, not medical or financial advice.